What is Morphine or Oxycodone?

They are types of strong painkiller used to control pain that has not been controlled by weaker pain medicines. They may also be used at low dose for breathlessness in palliative care.

There are many myths about strong painkillers. These can often cause fears and worries and may lead to pain not being well controlled. It can help to know some of the facts about these medicines. Our leaflet does not replace conversations with your doctor, nurse or pharmacist but reading it may help you decide what questions you want to ask.

How is this medication taken?

This medication is taken orally (by mouth) in either a tablet, capsule or liquid.  Depending on your individual needs these can be:

Quick or short acting

that works quickly for pain also sometimes referred to as ‘immediate release’ or for “breakthrough pain”. This medication can be in the form of tablets or liquid and in different strengths which are adjusted depending on your individual needs including if you are taking other pain relief medication. They start to work in about 20-30 minutes and last approximately 4 hours.

Long acting

that you take regularly twice a day to give you a continuous dose of painkiller also sometimes called ‘modified release’ or ‘sustained release’. They comes in a variety of strengths and either a capsule or a tablet. It is important to be take this medication regularly and at 12 hourly intervals, e.g. 9.00am and 9.00pm or 10.00am and 10.00pm.

What side effects should I look out for?

Constipation

They often cause constipation and a regular laxative is often needed. Eating more fruit, vegetables, brown bread, bran based cereals and drinking more fluid may also help.

Feeling sick or vomiting

This can happen when you first take it, but it usually only lasts a few days. Your health professional can prescribe anti sickness medication if necessary.

Drowsiness

Again is more likely when first starting or when increasing the dose. It commonly improves however make allowances in activities and take extra care if you are affected by drowsiness.

Less common side effects include:
  • unsteadiness
  • hallucinations
  • confusion
  • sweating
  • blurred vision
  • dry mouth

Seek prompt medical advice through your GP surgery or Out of Hours Doctor (CHOC) and in an emergency contact 999 if you are affected by the following:

  • Your pain gets worse and is not controlled by your current medication

  • Excessive drowsiness

  • You are feeling very sickly and vomiting

  • If you feel confused or muddled

  • If you experience bad dreams or hallucinations

  • If you feel very restless or jumpy

Frequently asked questions

Are oral Morphine or Oxycodone just used in palliative care?

No. They are widely used for pain control, although will have been individually prescribed for the person.

Does it work for all pain?

No. Not all pain is helped by morphine or oxycodone, your health professional will discuss this with you. It may be necessary to take other painkillers at the same time that work in a different way e.g. paracetamol.

Will I need a bigger and bigger dose to control the pain?

Not necessarily. However, many people do need to increase the dose from time to time particularly at the beginning of treatment in order to work out the right level of painkiller for you.

Is there a maximum dose?

No. Firstly, it is not inevitable that pain continues to get worse but if it does, there is no maximum dose. The dose is individually worked out according to your needs. This is often by increasing the dose gradually to match your pain.

Will I become addicted?

No. Taking morphine or oxycodone for pain in palliative care will not make you become an addict. If another treatment can relieve the pain we may reduce the dose but this should be done in a controlled way. You should not stop without discussion with your doctor or nurse.

What if these drugs work for the pain but have a lot of side effects? 

Some of the side effects can be managed, however there are a number of other medications available. Your health professional may suggest changing to an alternative.

How do I store opioids?

They should be stored in a cool, dark place in the original container. Make sure it is well out of reach of children, vulnerable adults and pets. Please return any unused medication to the pharmacy.

Can I take my medication abroad on holiday? 

Please consult your GP as you may require a letter. If you have any queries, please do not hesitate to contact your doctor, nurse or pharmacist. 

Can I drink alcohol?

Yes although be cautious and stick to small amounts of alcohol. Ideally wait until you are established on a stable oral opioid dose.

What about driving?

Please see separate leaflet on driving which has more information.

Remember – Ultimately the risk lies with you. It is an offence to drive whilst your ability is impaired, if in doubt, you should not drive. It is suggested that you carry a copy of your prescription or a used medicine packet when driving. For more information go to https://www.gov.uk/drug-driving-law

Confidentiality

‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.

For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302